How To Pick A Nursing Home

Attorney Mike Bottaro has 3 tips for selecting a nursing home in Rhode Island.

Many families struggle with the heart wrenching decision of placing a loved one in a skilled nursing facility.  Once the decision has been made, here are some important factors to consider before selecting a RI nursing home:

What Are Your Loved One’s Medical Issues?

By state and federal law, upon admittance nursing facilities must conduct an initial assessment of your loved one’s medical needs, including their functioning as to activities of daily living (“ADLs”).  Before this occurs, you should understand your loved one’s medical needs.  Speak with your loved one’s doctors and observe everything (some of my clients even keep a journal).  Once you understand the exact medical issues, you can better evaluate and interview potential nursing homes.  For example, dementia and Alzheimer’s patients have special needs that not every RI nursing home can adequately address.  Knowing your loved one’s medical needs will help you become an active advocate for your loved one.  When nursing homes may mistakes, this may help you minimize the effects of such mistakes or even prevent injury.

What should you learn about potential nursing facilities?

First and foremost, who owns and operates the facility? Many nursing homes are now owned by large corporate conglomerates that are not based in Rhode Island. Most experts urge consumers to seriously be wary of such nursing facilities, because they may overemphasize corporate profit over quality care.  The RI Secretary of State provides ownership information here.  Next, from my perspective as an RI personal injury lawyer including RI nursing home lawyer -- understaffing is a major concern. Some important questions to ask are: How many staff to patients are there (“staff-patient ratio”) on a given shift?  How many Resident Nurses (as opposed to Certified Nurse Assistants) are on duty each shift?  Finally, access the public records and ask specific questions about past deficiencies. There are minimum standards set forth in state and federal regulations.  The RI Department of Health maintains information here.  This agency also conducts inspections and any deficiencies cited are public record.  This is important because I have handled cases as an RI nursing home lawyer where falls and elopement (wandering from the facility) were substantially caused by understaffing and/or there was a pattern of neglect. 

 What Is The Facility’s Cost And Fine Print?

Although outside my realm as an RI personal injury lawyer, it is a good idea to consult with a Rhode Island attorney who advises on Medicaid/Medicare issues and financing a loved one’s stay at a nursing home.  That same lawyer should also be able to review the nursing home’s contract before you sign.  You may be surprised at the sources of funding available ... and of the terms in the contractual fine print.

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Celine April 16, 2012 at 05:02 PM
Just to add to this info, look at lighting and the affect of people aready living at the facility. Are people moving about or are they organized in a supervised group? Since these people are usually from different areas, there should be activities where they can make new friends and socialize in a comfortable manner. Is the staff familiar with persons' needs and comfort? Watching the staff interact with the clients gives a person some insight as to how situations are managed.
Mike Bottaro April 16, 2012 at 07:29 PM
This is an excellent point. You must have experience in the field, Celine. Visiting the facility and observing is a firsthand way to check out the care.


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